Building on the Best programme hits one-year anniversary

The Building on the best programme has reached its one-year anniversary. The programme brings together 10 NHS Trusts across England and recently added three more in Scotland and aims ‘to provide the support, knowledge and leadership so that everyone approaching end of life in hospital will receive quality of care that is safe and respects their personal wishes and needs’. Building on the best is a partnership led by the National Council for Palliative Care, working closely with Macmillan Cancer Support, NHS England and NHS Improvement. It is funded by Macmillan Cancer Support. 

Building on the best was launched in late March 2016, with a two-day residential event for staff from the 10 acute Trusts across England. The 10 Trusts were selected for their existing strong track record in delivering high quality end of life care. Hospitals in Scotland are also participating in their own parallel programmes, supported by the Scottish Partnership for Palliative Care.

The programme will run until March 2018.  At that point it is hoped that the sites will continue to work with each other in a ‘community of practice’.  In addition to this, learning from the programme and service improvement will be shared with hospitals across England.  The programme will be fully evaluated, and the lessons learnt, case studies and emerging best practice will be made available for wider dissemination. 

Staff from the 10 sites take part in regular WebEx meetings to share and learn from one another, and have also met at a one-day conference after the initial gathering and smaller cluster events. The emerging community of practice across the participating sites has been one of the factors driving the programme forward. The community of practice has proven so popular that it is expected to continue beyond March 2018, enabling staff to collaborate through the evaluation period and beyond. 

Claire Henry, Chief Executive of the NCPC said “it has been great to see the energy and enthusiasm when these groups get together. Each trust was chosen because it was already doing good work in end of life care, but each of them is great in different ways. By bringing them together they have could support each other and learn from one another, and we have could learn from them all. 

“I’m sure that over the final 18 months of the programme we will see this accelerate. What comes out of this will be of benefit to patients everywhere.”

Building on the best focuses on four key topic areas for improvement: making information more accessible to patients and their families, to enable shared decision making; taking the opportunities offered by outpatient appointments to discuss advance and anticipatory care planning; improving the handover of information and records as people move between acute and secondary care; and improving pain and symptom management. Each trust is concentrating on different combinations of these four, depending on their existing experience, the local context and the priorities already set by Trust quality improvement plans. 

The changes that emerge from the programme will be focused on what matters from a patient perspective, and will see trusts engaging more with people with experience to help develop improvement plans.

The participating trusts are: 
•   Basildon & Thurrock University Hospital NHSFT
•   Great Ormond Street Hospital NHSFT
•   Guys & St Thomas' Hospital NHSFT
•   University Hospitals Birmingham NHSFT
•   East and North Hertfordshire NHS Trust
•   Doncaster and Bassetlaw NHS Trust
•   Leeds Teaching Hospitals NHS Trust
•   Southport & Ormskirk NHS Trust
•   Poole Hospital NHSFT
•   Worcester Acute Hospitals NHS Trust